NSG 5140
Advanced Pathophysiology
Midterm & Final Exam Review
Questions & Answers with Rationales
South College
Contents
PART 1 — MIDTERM REVIEW
PART 2 — FINAL EXAM REVIEW
, PART 1: MIDTERM EXAM REVIEW
Q1. Which cellular adaptation describes an increase in cell size without an
increase in cell number?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in the size of individual cells, often in
response to increased workload (e.g., cardiac myocyte hypertrophy in
hypertension), and occurs in tissues with limited capacity for cell division such
as cardiac and skeletal muscle.
Q2. Reversible replacement of one differentiated cell type with another,
often in response to chronic irritation, is termed:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is a reversible adaptive change in which one adult cell
type is replaced by another that is better suited to withstand the ongoing stress,
such as the replacement of ciliated columnar epithelium with squamous
epithelium in the bronchi of chronic smokers.
Q3. Which type of cellular death is characterized by an orderly,
energy-dependent process without an inflammatory response?
A. Necrosis
, B. Apoptosis
C. Gangrene
D. Liquefactive necrosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death that proceeds through a
regulated cascade of caspase activation, resulting in cell shrinkage and
fragmentation into apoptotic bodies that are phagocytosed without releasing
intracellular contents, so it does not provoke inflammation, unlike necrosis.
Q4. Coagulative necrosis is most characteristic of ischemic injury in
which organ?
A. Brain
B. Heart
C. Lungs
D. Skin in gas gangrene
Correct Answer: B
Rationale: Coagulative necrosis preserves the basic tissue architecture for
several days after cell death due to denaturation of structural and enzymatic
proteins, and it is the typical pattern seen in ischemic injury to solid organs
such as the heart and kidney (e.g., myocardial infarction).
Q5. Hypoxic cell injury most directly impairs which cellular process first?
A. Protein synthesis on the rough endoplasmic reticulum
B. Oxidative phosphorylation and ATP generation in the mitochondria
C. DNA replication in the nucleus
D. Lysosomal enzyme packaging in the Golgi apparatus
Correct Answer: B
Rationale: Hypoxia reduces oxidative phosphorylation, rapidly depleting ATP;
this loss of energy impairs the sodium-potassium pump, causing cellular
swelling, and disrupts other ATP-dependent processes, making it the initiating
event in hypoxic injury.
Q6. Free radical-mediated cell injury primarily damages cells through
which mechanism?
, A. Direct enzymatic digestion of the nucleus
B. Lipid peroxidation of cell membranes, protein cross-linking, and DNA
fragmentation
C. Complement-mediated cell lysis
D. Osmotic lysis from water influx alone
Correct Answer: B
Rationale: Free radicals are highly reactive species that attack
polyunsaturated lipids in cell membranes (lipid peroxidation), cross-link
proteins, and cause single- and double-strand DNA breaks, all of which
contribute to structural and functional cell damage.
Q7. A disorder that manifests when only one copy of a mutant allele is
inherited follows which inheritance pattern?
A. Autosomal recessive
B. Autosomal dominant
C. X-linked recessive
D. Mitochondrial
Correct Answer: B
Rationale: Autosomal dominant disorders require only a single copy of the
mutant allele on one of the paired autosomes for the phenotype to be
expressed, meaning an affected parent has a 50% chance of passing the
condition to each offspring.
Q8. Which chromosomal abnormality results in Down syndrome in the
majority of cases?
A. Deletion of part of chromosome 5
B. Trisomy 21 (nondisjunction)
C. Monosomy X
D. Balanced translocation between chromosomes 9 and 22
Correct Answer: B
Rationale: Most cases of Down syndrome result from nondisjunction during
meiosis, producing an extra copy of chromosome 21 (trisomy 21); the extra
genetic material disrupts normal development, producing the characteristic
phenotype and associated comorbidities.
Q9. A woman is a carrier for an X-linked recessive disorder. What is the
Advanced Pathophysiology
Midterm & Final Exam Review
Questions & Answers with Rationales
South College
Contents
PART 1 — MIDTERM REVIEW
PART 2 — FINAL EXAM REVIEW
, PART 1: MIDTERM EXAM REVIEW
Q1. Which cellular adaptation describes an increase in cell size without an
increase in cell number?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in the size of individual cells, often in
response to increased workload (e.g., cardiac myocyte hypertrophy in
hypertension), and occurs in tissues with limited capacity for cell division such
as cardiac and skeletal muscle.
Q2. Reversible replacement of one differentiated cell type with another,
often in response to chronic irritation, is termed:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is a reversible adaptive change in which one adult cell
type is replaced by another that is better suited to withstand the ongoing stress,
such as the replacement of ciliated columnar epithelium with squamous
epithelium in the bronchi of chronic smokers.
Q3. Which type of cellular death is characterized by an orderly,
energy-dependent process without an inflammatory response?
A. Necrosis
, B. Apoptosis
C. Gangrene
D. Liquefactive necrosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death that proceeds through a
regulated cascade of caspase activation, resulting in cell shrinkage and
fragmentation into apoptotic bodies that are phagocytosed without releasing
intracellular contents, so it does not provoke inflammation, unlike necrosis.
Q4. Coagulative necrosis is most characteristic of ischemic injury in
which organ?
A. Brain
B. Heart
C. Lungs
D. Skin in gas gangrene
Correct Answer: B
Rationale: Coagulative necrosis preserves the basic tissue architecture for
several days after cell death due to denaturation of structural and enzymatic
proteins, and it is the typical pattern seen in ischemic injury to solid organs
such as the heart and kidney (e.g., myocardial infarction).
Q5. Hypoxic cell injury most directly impairs which cellular process first?
A. Protein synthesis on the rough endoplasmic reticulum
B. Oxidative phosphorylation and ATP generation in the mitochondria
C. DNA replication in the nucleus
D. Lysosomal enzyme packaging in the Golgi apparatus
Correct Answer: B
Rationale: Hypoxia reduces oxidative phosphorylation, rapidly depleting ATP;
this loss of energy impairs the sodium-potassium pump, causing cellular
swelling, and disrupts other ATP-dependent processes, making it the initiating
event in hypoxic injury.
Q6. Free radical-mediated cell injury primarily damages cells through
which mechanism?
, A. Direct enzymatic digestion of the nucleus
B. Lipid peroxidation of cell membranes, protein cross-linking, and DNA
fragmentation
C. Complement-mediated cell lysis
D. Osmotic lysis from water influx alone
Correct Answer: B
Rationale: Free radicals are highly reactive species that attack
polyunsaturated lipids in cell membranes (lipid peroxidation), cross-link
proteins, and cause single- and double-strand DNA breaks, all of which
contribute to structural and functional cell damage.
Q7. A disorder that manifests when only one copy of a mutant allele is
inherited follows which inheritance pattern?
A. Autosomal recessive
B. Autosomal dominant
C. X-linked recessive
D. Mitochondrial
Correct Answer: B
Rationale: Autosomal dominant disorders require only a single copy of the
mutant allele on one of the paired autosomes for the phenotype to be
expressed, meaning an affected parent has a 50% chance of passing the
condition to each offspring.
Q8. Which chromosomal abnormality results in Down syndrome in the
majority of cases?
A. Deletion of part of chromosome 5
B. Trisomy 21 (nondisjunction)
C. Monosomy X
D. Balanced translocation between chromosomes 9 and 22
Correct Answer: B
Rationale: Most cases of Down syndrome result from nondisjunction during
meiosis, producing an extra copy of chromosome 21 (trisomy 21); the extra
genetic material disrupts normal development, producing the characteristic
phenotype and associated comorbidities.
Q9. A woman is a carrier for an X-linked recessive disorder. What is the
